Gang Deng, Chenchen Liu, Yihui Wang, Donghui Ao, Yi Zhang, Guo Li, Shabei Xu, Xiang Luo
In this exploratory randomized trial, prophylactic intra-arterial NV did not significantly reduce clinical RAS during diagnostic TRCA. GSS use was associated with higher rates of clinical RAS and RAO under the evaluated procedural conditions. These findings should be interpreted cautiously and require validation in future studies.
PURPOSE: To evaluate the independent and interaction effects of prophylactic intra-arterial nitroglycerin-verapamil versus saline and a 6 Fr Glidesheath Slender versus a conventional 6 Fr sheath on clinical radial artery spasm during diagnostic transradial cerebral angiography.
MATERIALS AND METHODS: In this prospective, single-center, 2 × 2 factorial randomized trial, 255 patients undergoing diagnostic TRCA were assigned to prophylactic intra-arterial NV or saline and radial access with either GSS or conventional 6 Fr sheath (CS). The primary outcome was clinical RAS. Secondary outcomes included radial artery occlusion (RAO) and procedural outcomes.
RESULTS: Clinical RAS occurred more frequently with GSS than with CS (33.9% vs 18.8%, P = .003). NV did not significantly reduce RAS compared with saline (29.7% vs 21.7%, P = .149). RAO was also higher with GSS (23.6% vs 11.7%, P = .022). After adjustment for prespecified covariates, GSS use remained associated with clinical RAS.
CONCLUSION: In this exploratory randomized trial, prophylactic intra-arterial NV did not significantly reduce clinical RAS during diagnostic TRCA. GSS use was associated with higher rates of clinical RAS and RAO under the evaluated procedural conditions. These findings should be interpreted cautiously and require validation in future studies.